The Client

Located in Jefferson, Indiana, Clark Memorial Hospital is where Southern Indiana residents go for state-of-the-art treatment and quality care.

The Challenge

Complex hospital pharmacy operation with 3,000+ inventoried items needs to track movement and administration of medication as part of their Barcode Initiative

Clark Memorial Hospital's barcode initiative requires that patients receive a unique barcoded wristband upon admission. It also requires that all medications carry a barcode label at the point of patient administration. Barcode technology reduces adverse events stemming from medication misadministration and helps reinforce the Five Rights of Medication Administration: Right Patient, Right Medication, Right Time, Right Dose, and Right Route.

The NDC number is printed as a 2D barcode on the medication’s container by its manufacturer.
2D barcodes are used because of their compact size, built-in error correction and relative insensitivity to the reading angle of the barcode scanner, but Clark Memorial discovered the drugs often carried poorly printed or hard-to-read barcode labels.

“The FDA mandated that all vendors of medications must add a barcode, but they didn’t mandate the quality of the barcode,” said Gary Pollock MS, RN, MT (ASCP), Pharmacy Systems Administrator at Clark Memorial Hospital. “Sometimes a barcode is wrapped around a tiny vial, and the curvature of the vial prevents our scanner from reading the 1D linear barcode. Others are printed on paper that doesn’t carry crisp, readable barcodes or they have reflective foil that makes the code difficult to read.”

The Solution

After searching for an alternative labeling method, Pollock found WaspLabeler + 2D Barcode Labeling Software and chose to adopt the software for Clark Memorial's re-labeling needs.

The WaspLabeler + 2D Barcode Labeling Software produces both 1D linear barcodes and 2D barcodes for Clark Memorial Hospital. "2D barcodes are physically smaller so we can place them on the small vials, medications and packets," said Pollock.

The Result

An immediate application was relabeling patient controlled analgesia (PCA) medication cartridges with barcode labels that were readable by the hospital's Smart IV Pumps. Wasp's software easily created labels that could be read by the pumps as the medication cartridge was inserted by the nurse. This enabled a cross-check on the drug programmed by the nurse and assured compatibility with the type of medication being dispensed, decreasing the risk of human error and, of course, improving patient safety.

One vial of insulin holds three milliliters, about a thimbleful, of medication and costs approximately $50. Prior to Wasp, nurses had to discard any additional medication in vial after administration. Now, it would be possible to safely re-label and reuse these vials by flagging it with the WaspLabeler + 2D. In the case of insulin, nurses withdraw the appropriate amount of medication into a syringe (usually around 5/100's of a milliliter), enter the patient's room with only the necessary amount of insulin, and re-label the remaining, uncontaminated insulin for re-use.

"The WaspLabeler + 2D Barcode Labeling Software is great," said Pollock. "It saves us money and time, but more importantly, it will have an impact on decreasing medication administration errors and improve patient safety. Wasp's solutions were easy to implement and even easier to learn."